Hiccups can be idiopathic, psychogenic and organic, with drugs being one of the most important causes of hiccups. Although the exact pathophysiological processes involved are still poorly understood, the neurotransmitters dopamine, serotonin, and γ-aminobutyric acid (GABA) have been documented to play a significant role in the generation of hiccups. We report on two patients with cellulitis who developed hiccups with the use of tramadol as an analgesic. The possible mechanisms and clinical implications of this rare adverse event are discussed. Both patients recovered from the hiccups with the use of baclofen tablets.
Background: Echinococcosis is caused by parasite called Echinococcus granulosus and Echinococcus multilocularis. The modern treatment of hydatid cyst of the liver varies from surgical intervention to percutaneous drainage or medical therapy.Methods: This clinical study was done on 50 patients who had liver hydatid disease admitted in Sir T Hospital, Bhavnagar from August 2013 to February 2016. Patients were divided into two groups consisting of 25 cases in each. Group A: managed by open surgery. Group B: managed by laparoscopic surgery. All patients followed up for 6 months after surgery.Results: The mean operative time in Group A was 65.2 minutes (range 35-100 minutes) while in Group B it was 76.32 minutes (range 50-100 minutes). Group B patients were mobilised early and resumed duty very fast then Group A. The mean duration of stay in hospital was 12.4 days (range 4-20 days) in Group A and 6.2 days (range 4-12 days) in Group B. Wound infection seen in 16% in Group A and 0% in Group B. General complication rate was 32% in Group A and 8% in Group B. No recurrence noticed in either group during follow up.Conclusions: Overall laparoscopic management of liver hydatid cyst is cost effective in terms of early mobilization, early discharge and early resumption of work along with cosmetic benefit.
Introduction: Dilated & tortuous subcutaneous veins 3mm or more in diameter are known as varicose veins. When perforating veins become incompetent, it causes chronic venous insufficiency. Majority cases are managed conservatively. Cases with significant skin changes and ulcers, requires surgical procedures.
Methods: A prospective comparative study of 30 patients of varicosities, divided into two groups, A and B according to CEAP classification were assessed for VCSS preoperatively. They underwent radiofrequency ablation (RFA) and subfascial endoscopic perforator surgery (SEPS) respectively and postoperative VCSS was calculated at follow up at 4 weeks. Collected data was assessed for the change in clinical severity of the disease and compared for the complications of both surgical methods.
Results: The mean difference of pre op and post op VCSS in patient treated by RFA is 6.0 and the mean difference of pre op and post op VCSS in patient treated by SEPS is 5.4. Post RFA complications include pain (20%) and ecchymosis (13.3%). Paraesthesia and DVT was not noted. Post SEPS complications include pain (40%), ecchymosis (40%) and paresthesia (13.33%). DVT was not noted post SEPS. Only 1 case (6.66%) treated by SEPS developed recurrence post operatively. Conclusion: RFA and SEPS are two different approaches for varicosities, RFA being truncal therapy and SEPS for perforators, both are almost equally effective in context of postoperative hospital stay and improvement of VCSS; safe in terms of post op complications.
Keywords: Radiofrequency ablation (RFA), Subfascial endoscopic perforator surgery (SEPS), venous clinical severity score (VCSS), varicose veins
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.